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	    <title>中华人民共和国海关出口货物报关单</title>
	
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	</head>
	<body>
		
		<div id="header"></div>
		
	    <form class="container main form-horizontal" method="post" name="">	
		    <!--面板/基本信息-->
		    <div class="panel panel-default" id="informationBasic">
				<div class="panel-heading">
				    <h3 class="panel-title">中华人民共和国海关出口货物报关单</h3>
				</div>	
				<div class="panel-body">
					
					<div class="row">
						<!--出口口岸-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">出口口岸：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="出口口岸" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--备案号-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">备案号：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="备案号" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--出生日期-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">出生日期：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="出生日期" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--申报日期-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">申报日期：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="申报日期" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--经营单位-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">经营单位：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="经营单位" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--运输方式-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">运输方式：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="运输方式" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--运输工具名称-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">运输工具名称：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="运输工具名称" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--提运单号-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">提运单号：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="提运单号" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--发货单位-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">发货单位：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="发货单位" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--贸易方式-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">贸易方式：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="贸易方式" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--征免性质-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">征免性质：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="征免性质" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--结汇方式-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">结汇方式：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="结汇方式" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--许可证号-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">许可证号：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="许可证号" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--运抵国（地区）-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">运抵国（地区）：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="运抵国（地区）" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--指运港-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">指运港：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="指运港" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--境内货源地-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">境内货源地：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="境内货源地" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--批准文号-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">批准文号：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="批准文号" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--成交方式-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">成交方式：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="成交方式" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--运费-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">运费：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="运费" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--保费-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">保费：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="保费" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--杂费-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">杂费：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="杂费" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--合同协议号-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">合同协议号：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="合同协议号" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--件数-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">件数：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="件数" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--包装种类-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">包装种类：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="包装种类" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--毛重（公斤）-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">毛重（公斤）：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="毛重（公斤）" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--净重（公斤）-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">净重（公斤）：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="净重（公斤）" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--集装箱号-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">集装箱号：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="集装箱号" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--随附单据-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">随附单据：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="随附单据" title="请输入..." />
							    </div>
							</div>
						</div>
						<!--生产厂家-->
						<div class="col-lg-4 col-md-6">
							<div class="form-group">
							    <label class="col-md-3 control-label">生产厂家：</label>
							    <div class="col-md-9">
							      	<input type="text" class="form-control" placeholder="生产厂家" title="请输入..." />
							    </div>
							</div>
						</div>
						
					</div>
					
					<!--标记唛码及备注-->
					<div class="form-group">
					    <label class="col-md-1 control-label">标记唛码及备注：</label>
					    <div class="col-md-11">
					      	<textarea class="form-control" placeholder="标记唛码及备注" title="请输入..."></textarea>
					    </div>
					</div>
					
					<!--table-->
					<table class="table table-striped table-striped-change" id="goodForm">
						<thead>
						    <tr>
							    <th>项号</th>
							    <th>商家编号</th>
							    <th>商品名称、规格型号</th>
							    <th>数量及单位</th>
							    <th>最终目的（地区）单价</th>
							    <th>总价</th>
							    <th>币制</th>
							    <th>征免</th>
						    </tr>
						</thead>
						<tbody>
						    <tr>
							    <td><input type="text" class="form-control" placeholder="项号" title="请输入..." /></td>
							    <td><input type="text" class="form-control" placeholder="商家编号" title="请输入..." /></td>
							    <td><input type="text" class="form-control" placeholder="商品名称、规格型号" title="请输入..." /></td>
							    <td><input type="text" class="form-control" placeholder="数量及单位" title="请输入..." /></td>
							    <td><input type="text" class="form-control" placeholder="最终目的（地区）单价" title="请输入..." /></td>
							    <td><input type="text" class="form-control" placeholder="总价" title="请输入..." /></td>
							    <td><input type="text" class="form-control" placeholder="币制" title="请输入..." /></td>
							    <td><input type="text" class="form-control" placeholder="征免" title="请输入..." /></td>
						    </tr>
						    <tr>
							    <td><input type="text" class="form-control" placeholder="项号" title="请输入..." /></td>
							    <td><input type="text" class="form-control" placeholder="商家编号" title="请输入..." /></td>
							    <td><input type="text" class="form-control" placeholder="商品名称、规格型号" title="请输入..." /></td>
							    <td><input type="text" class="form-control" placeholder="数量及单位" title="请输入..." /></td>
							    <td><input type="text" class="form-control" placeholder="最终目的（地区）单价" title="请输入..." /></td>
							    <td><input type="text" class="form-control" placeholder="总价" title="请输入..." /></td>
							    <td><input type="text" class="form-control" placeholder="币制" title="请输入..." /></td>
							    <td><input type="text" class="form-control" placeholder="征免" title="请输入..." /></td>
						    </tr>
						</tbody>
					</table>
					
					<!--税费征收情况-->
					<div class="form-group">
					    <label class="col-md-1 control-label">税费征收情况：</label>
					    <div class="col-md-11">
					      	<textarea class="form-control" placeholder="税费征收情况" title="请输入..."></textarea>
					    </div>
					</div>
					
				</div>
			
			</div>
		
		    <!--提交submit-->
		    <!--<button type="submit" class="btn btn-primary btn-lg sub-btn pull-right">提交</button>-->
		    <a href="home.html" class="btn btn-primary btn-lg sub-btn pull-right">提交</a>
    	
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